Wednesday, September 26, 2018
Health

About that insomnia ...

Insomnia is like a thief in the night, robbing millions — especially those older than 60 — of much-needed restorative sleep.

The causes of insomnia are many, and they increase in number and severity as people age. Yet the problem is often overlooked during checkups, which not only diminishes the quality of an older person's life but may also cause or aggravate physical and emotional disorders, including symptoms of cognitive loss.

Most everyone experiences episodic insomnia, a night during which the body seems to have forgotten how to sleep a requisite number of hours, if at all. As distressing as that may seem at the time, it pales in comparison to the effects on people for whom insomnia — difficulty falling asleep, staying asleep or awakening much too early — is a nightly affair.

A 1995 National Institute on Aging survey of more than 9,000 people 65 and older revealed that 28 percent had problems falling asleep and 42 percent reported difficulty with both falling asleep and staying asleep. The numbers affected are likely to be much larger now that millions spend their presleep hours looking at electronic screens that can disrupt the body's biological rhythms.

Insomnia, Dr. Alon Y. Avidan says, "is a symptom, not a diagnosis" that can be a clue to an underlying and often treatable health problem and, when it persists, should be taken seriously. Avidan is director of the sleep clinic at the University of California, Los Angeles, David Geffen School of Medicine.

So-called transient insomnia that lasts less than a month may result from a temporary problem at work or an acute illness; short-term insomnia lasting one to six months may stem from a personal financial crisis or loss of a loved one. When insomnia becomes chronic, lasting six months or longer, it can wreak serious physical, emotional and social havoc.

In addition to excessive daytime sleepiness, which can be dangerous, Avidan says chronic insomnia "may result in disturbed intellect, impaired cognition, confusion, psychomotor retardation or increased risk for injury." It is often accompanied by depression.

There are two types of insomnia. Primary insomnia results from a problem that occurs only or mainly during sleep, like obstructive sleep apnea or restless leg syndrome.

The other, more common type of insomnia is secondary to an underlying medical or psychiatric problem; the side effects of medications; behavioral factors like ill-timed exposure to caffeine; or environmental disturbances like excessive noise or light in the bedroom.

Among the many medical conditions that can cause insomnia are heart failure, gastroesophageal reflux, lung disease, arthritis and Alzheimer's disease. Treating the underlying condition often relieves the insomnia.

Nonmedical causes of insomnia can often be treated by practicing "good sleep hygiene": limiting naps to less than 30 minutes a day, preferably early in the afternoon; avoiding stimulants and sedatives; avoiding heavy meals and minimizing liquids within two to three hours of bedtime; getting moderate exercise daily, preferably in the morning or early afternoon; maximizing exposure to bright light during the day; creating comfortable sleep conditions; and going to bed only when you feel sleepy.

If you still can't fall asleep within about 20 minutes in bed, experts recommend leaving the bedroom and doing something relaxing, like reading a book (one printed on paper), and returning to bed when you feel sleepy.

For those who still need help with insomnia, cognitive behavioral therapy has proved most effective in clinical trials.

Sleeping pills can be problematic, but over-the-counter remedies like melatonin or valerian, which have more anecdotal evidence than research to attest to their efficacy, are available.

There may also be some useful dietary aids, like bananas, cherries, kiwis, oatmeal, milk and chamomile tea, though evidence for these is also primarily anecdotal.

Comments
Don’t go overboard on those abs

Don’t go overboard on those abs

Strengthening abdominal muscles seems to be at the top of the exercise to-do list for many exercise enthusiasts. However, according to exercise pros, many people are going about it the wrong way. And it doesn’t help that abdominal workouts are still ...
Published: 09/25/18
Too late for many, Florida’s prescription database is finally mandatory

Too late for many, Florida’s prescription database is finally mandatory

This is a story of success. Or maybe it’s a cautionary tale.The difference, I suppose, is whether you are haunted by the lives ruined and lost, or you are focused on the path going forward. Either way, you need to understand the history and the playe...
Published: 09/22/18
Tampa General nurses record the last heartbeats of dying patients, making a family memory

Tampa General nurses record the last heartbeats of dying patients, making a family memory

TAMPA — As John Reisinger waited with family at Tampa General Hospital, grief settled in like a fog. So some of the details are hazy.But he remembers the moment when three women in white lab coats approached him.The day before, his niece, Jessica Rau...
Published: 09/21/18
I was hospitalized for my eating disorder. Here's what Netflix shows get right and wrong about it.

I was hospitalized for my eating disorder. Here's what Netflix shows get right and wrong about it.

It took me a year and a half to watch Netflix’s To the Bone. The movie, which debuted in January 2017, portrays Ellen, a 20-year-old woman battling anorexia nervosa, and her experience being in and out of various treatment programs. When it w...
Published: 09/20/18
Updated: 09/21/18
All Children’s unveils a $95 million research center. Next step: ‘Cure some diseases.’

All Children’s unveils a $95 million research center. Next step: ‘Cure some diseases.’

ST. PETERSBURG — "Vicky Hopkins" is 37 weeks pregnant and splayed on a bed at Johns Hopkin’s All Children’s Hospital. Four obstetricians surround her as she groans."My back is killing me," she complains, but she keeps pushing. Soon the round shape of...
Published: 09/20/18
Watchdog slams safeguards for foster kids on psych drugs

Watchdog slams safeguards for foster kids on psych drugs

WASHINGTON — Thousands of foster children may be getting powerful psychiatric drugs prescribed to them without basic safeguards, says a federal watchdog agency that found a failure to care for youngsters whose lives have already been disrupted...
Published: 09/17/18
Doctors dismissed her, but she turned out to be right after years of needless suffering

Doctors dismissed her, but she turned out to be right after years of needless suffering

The prominent New York City gynecologist didn’t bother to conceal his disdain."Stop practicing Google medicine," Lina Kharnak remembers the doctor chiding her when she asked about a possible cause of her worsening leg and back pain. The disease about...
Published: 09/16/18
Updated: 09/17/18
Tampa General Hospital’s East Pavilion advised not to use running water after water main break

Tampa General Hospital’s East Pavilion advised not to use running water after water main break

Since Saturday morning, patients and staff in Tampa General Hospital’s East Pavilion and Rehabilitation Center have been advised against using running water.As of Sunday afternoon, it was not known when the recommended ban would be lifted.According t...
Published: 09/16/18
Anger management: Learn healthy ways to handle it, and unlearn bad behavior

Anger management: Learn healthy ways to handle it, and unlearn bad behavior

What makes you mad? Dropping your new phone in the toilet — after deciding not to take the extra coverage that would have replaced it? Being cut off in traffic? Having a parking place "stolen" from you? Doing dishes after shopping for and cooki...
Published: 09/14/18
Red Tide outbreak can be particularly bad for people with asthma or allergies

Red Tide outbreak can be particularly bad for people with asthma or allergies

The toxic algae bloom known as Red Tide has left a trail of dead fish in its wake up the western coast of Florida. The bloom that had been wreaking havoc on our southern neighbors has now made its way to the Tampa Bay area. High concentrations of the...
Published: 09/14/18